Adults use smoking cessation smartphone app more with access to digital pet game

Key takeaways:

• A pet dragon symbolized smoking cessation progress.
• The average number of days with an app session was elevated among adults with game access.
• Researchers did not observe significant differences in abstinence.

Current adult smokers with access to a digital pet game within a smoking cessation app had better app engagement and program adherence vs. those without game access, according to results published in Journal of Medical Internet Research.

“We know that standard treatments for smoking cessation, such as counseling and prescription medications, are effective, but if many people are turning to these types of apps, we have to meet individuals where they are,” Justin S. White, PhD, associate professor of health law, policy and management at Boston University School of Public Health, said in a press release.

“Embedding gamification within an app that we already know is evidence-based and effective, along with behavioral science tools, can be a really promising approach,” White continued.

In a parallel-group, two-arm, randomized controlled trial, White and colleagues evaluated 479 current adult smokers (at least one cigarette a day; median age, 36 years; 74.7% women; 76.8% non-Hispanic white) with a plan to quit within 7 days to measure how a digital pet game within the Smoke Free app (23 Limited) for smoking cessation impacts several user engagement endpoints, program adherence, smoking abstinence and app satisfaction during an 8-week period.

Within the total cohort, 241 adults (median age, 38 years; 73.4% women; 77.2% non-Hispanic white) had access to the Smoke Free app and the Inner Dragon game, whereas the remaining 238 adults (median age, 35 years; 76.1% women; 76.5% non-Hispanic white) only had access to the Smoke Free app.

“In Inner Dragon, an evolving pet dragon keeps users engaged with the game and app by serving as a visual representation of their progress in their quit attempts and, more broadly, their personal growth,” White said in the release.

Between the two groups, researchers found a higher number of sessions of Smoke Free in the group with vs. without access to the game (mean, 29.6 sessions vs. 24.3 sessions).

In terms of time spent on the app per session, those with game access had an average of 6.9 minutes, whereas those without game access had an average of 6.1 minutes (P = .047).

The average number of days with a session was also significantly elevated among adults with access to Inner Dragon compared with adults without access to Inner Dragon (14.3 days vs. 11.9 days; P = .03), according to researchers.

In the group with game access, the “diary and cravings log, guidance on quitting, daily task suggestions to help resist urges and calculator to track the amount of money saved from not buying cigarettes” within the Smoke Free app, classified as “core features” in the release, were used an average of 29.4 times, whereas these features were used less in the group without game access, with an average of 22.6 times (P = .03).

Researchers did not observe significant differences in self-reported and verified point-prevalence abstinence data collected at week 8 between those with access to Inner Dragon and those without access to Inner Dragon.

Further, the two sets of adults had similar values for app satisfaction and motivation to quit, according to the study.

One outcome that did significantly differ between the groups was mean repeated 1-day prevalence of quitting (17.3% vs. 12.4%; P = .01), researchers reported.

After dividing the group with game access based on lower vs. higher intensity of game use, researchers noted a link between higher intensity and heightened program adherence, as well as greater self-reported smoking abstinence.

“Every time users opened the app, it asked if they had smoked in the last day, and on that measure, there was a substantial improvement,” White said in the release. “Moreover, participants who used the game more often were more likely to abstain from smoking.”

As opposed to vaping devices that feature digital games, this smartphone app demonstrates that games can be used to assist individuals in utilizing a smoking cessation program regularly.

Reference:

• Novel digital pet game within smoking cessation app increases user engagement with app’s tools to quit smoking. https://www.bu.edu/sph/news/articles/2024/novel-digital-pet-game-within-smoking-cessation-app-increases-user-engagement-with-apps-tools-to-quit-smoking/. Published Nov. 1, 2024. Accessed Nov. 4, 2024.